When life is busy and demanding, it’s easy to overlook small ways you’ve improved yourself and your circumstances. This is particularly the case if you’re self-critical and tend to most easily see and recall what you’re doing wrong.
My kids are all adopted from foster care. I got my girls when they were five and six, and my son came when he was seven. They all came from abusive or neglectful pasts and have struggled with their mental health since before they first stood on my doorstep. And before you ask: Yes, I had been fully prepped on their family histories before I adopted them.
My son’s official diagnosis is Disruptive and Dysregulated Mood Disorder with PTSD flashbacks. He has a family history of schizophrenia and had been severely abused by his birth family. Last year, a prank pulled on him by another boy triggered horrible memories that my son’s mind had locked away. Now, he hallucinates. He dissociates. He hears voices.
I remember sitting in a counselor’s office, staring intently at a picture on the wall as my son told the counselor about the voices he heard and the things he saw that I knew didn’t exist. My son talked about a hand that came over our car and a shadow that came out of his bedroom wall. I tried so hard to concentrate on the picture so I wouldn’t cry. It didn’t work. When the tears began to roll down my face, I was careful not to make a sound. The counselor noticed, so he spoke reassuringly to me, “A lot of things can make a person see things that are not there.”
My son explained how hard it is for him to determine that these things aren’t real, because they feel real to him. He just wanted them to stop. The counselor thanked my son for telling him about what happened and told him he believed him. We went from the counselor’s office to the psychiatrist’s office, where my son had to tell the story again. I never realized how tired you can get from just listening. I was exhausted, and nothing was even happening to me.
Sometimes, I try to imagine what my son is going through, and I wonder if I could get up the next day if I were him. I honestly don’t know. My children are the strongest people I know. They keep going, despite anything and everything that tries to stop them. And I do my very best to help as their mother.
Raising children with mental health conditions is challenging. Patience can wear thin, because you want your child to do the things you need them to do. Frustration can leak into your communication. Walls can go up. Instead of loving each other, you feel like you’re at war.
When I really examined my frustrations, I noticed a lot of my anger came from a place of shame. I wanted my kids to act “appropriately” in public. When they didn’t, I would get frustrated. I cared more about what others thought of me than what my children thought of me—but that was getting my family nowhere. It especially wasn’t helping my children and their recovery.
If you’re a parent raising children with mental illness, I want more than anything for you not to make the same mistakes I made. So here are some of the most crucial lessons I’ve learned about supporting a child experiencing mental illness:
• A diagnosis provides a roadmap to recovery. How can you start on a journey if you don’t know your first step? Understanding your child’s diagnosis is critical. This knowledge can help you find ways to cope. For example, my son went through psychological testing after his
first suicide attempt. His symptoms had impaired his thinking so much that he lost three grade levels of reading comprehension. That was crushing to hear, since we had spent several years working to overcome his reading disability. But having him tested gave us a game plan.
• Open communication is key. Make sure you’re not shutting off communication before you give your child a chance to explain how they feel. Don’t come to any conversation with the idea that you already know all the answers or how to fix everything. If we took all the energy we initially spend as parents trying to “fix” our children who live with mental illness and instead focused that energy on understanding them, we would get them the right help faster. It’s amazing the answers you can get and the solutions you can come up with together if you first start conversations with respect and empathy.
• Care for yourself, too. It’s called self-care. When I first heard about it, I laughed. When do I have time for that? I’m a single parent. I work all day and then my kids need me. But what kind of “me” do they need? A healthy one, a happy one, a supportive one. So, plan time for yourself. Find an outlet. Find support. I love walking, blasting music when I drive by myself, writing, painting, gardening and anything that reminds me I am alive. I now know that the best parents are like flight attendants: If we hit rough patch and the oxygen masks drop, put your own mask on first before you help anyone else.
• A family crisis plan is crucial. I learned in NAMI Family-to-Family that a mental health crisis plan needs to be in place before your family is in crisis. So, on a calm day, I asked each of my kids what we should we do if we have another mental health crisis. Their responses, to this day, are some of the most insightful and caring suggestions I have ever heard. My oldest daughter wanted consequences for someone not following family rules or hurting others. My middle daughter wanted us to “talk things out if things get bad.” My son’s contribution was that he wanted everyone to be kind. It’s funny; as parents, we have the answers if we just ask questions and listen.
Acceptance is the first step for a person’s mental health recovery. Self-acceptance is important, but just as important is receiving acceptance from loved ones. Accepting your child’s condition doesn’t mean that you aren’t scared. It just means that you see the problem for what it is—not the person as being the problem. We must accept and believe our loved ones to start getting them help. If we don’t, we run the risk of being the reason they don’t get help.
We can’t discount or ignore our loved ones’ thoughts, feelings and behaviors just because we don’t understand them or wish they were different. We have to do better than that. We need to seek to understand their reality. We need to truly listen to what they say. Do not listen to speak or refute, but listen to understand.
As parents, we must be open. We must be open to all there is to learn—even when something scares us. If we are open, then those living with mental illness (including our own children) have a chance. How many people are out there right now feeling alone, struggling with the fear of rejection from the ones they love because they hear voices or see hallucinations? How many are alone and feeling lost, but are more afraid of losing the ones they love than dealing with their mental anguish?
I remember thinking how simple and matter-of-fact my son’s counselor was when he said those three simple words, “I believe you.” I also remember how relieved my son seemed after he heard them. Odds are, your children won’t go to a counselor when they first feel something isn’t quite right. They’ll come to you. So please, stay open and believe them. Believe them so they don’t have to be alone. Believe them so they can get help. Believing may save their lives.
Melinda Cook is a 43-year-old single parent of three. Before she became a foster mother, she worked for a shelter for abused women and children. She is now a Certified Family Support Partner through the Department of Health and Welfare for The Family Resource Center in Idaho Falls, Idaho, a local counseling company. She began writing about her son’s experiences to help others and writes a blog at myfamilyunbottled.weebly.com.
https://www.nami.org/Blogs/NAMI-Blog/October-2018/Raising-Children-with-Mental-Illness
Sometimes life can feel like a burden. It can feel like each day is a challenge. As if making it to your bed at the end of the day is like reaching the finish line of a long race. It can feel as if each interaction is a struggle. As if you only have a limited amount of oxygen, and each word you speak is a drain on your supply.
For those of you who have ever thought about suicide, you know this feeling all too well.
You’re strong for still being here even when your thoughts tell you that being alive isn’t worth the pain. You are strong for carrying the weight of it all on your shoulders for so long. For carrying it by yourself even while thinking you were alone in the way you feel—even while believing that no one and nothing out there could take off some of the weight.
We are a whole community of people who understand what you’re facing. And more than anything, we want to help you. You don’t have to go through this alone. We want you to ask us for help. We want to help you carry that heavy weight because we understand what it’s like to burden it alone. We may not know exactly what you’re facing, but we understand what it’s like to feel hopeless.
There are resources. There is help. There is support. There is time. Time that forces everything to change. You may not feel okay today, but that is okay. The awful way you feel is not permanent. You may feel like you can’t bear the pain any longer, you may feel like you don’t have it in you to reach out for help, but you are stronger than you know, and we believe in you.
You are worthy. You are important. Your life is important. You deserve a place on this planet, and we deserve to have you with us.
You have faced more than many can fathom and yet here you stand. Your strength is a source of hope for those who feel the same as you do. Not only should you feel comfortable telling us about your darkest moments, but we want to hear it.
To feel shame is, unfortunately, part of our experience. But it is not fair. It is not fair to yourself. Because the way you feel is not your fault. You should never blame yourself for your darkness. Your darkness if a part of your story, and we accept you.
Laura Greenstein is communications manager at NAMI.
https://www.nami.org/Blogs/NAMI-Blog/September-2018/We-Want-You-Here
Stigma is a shield created by society, made up of misunderstanding and fear of mental illness. When we look away from someone behaving erratically or “strangely” on the street, that’s the fear society ingrains in us. Perhaps we’re scared to consider the possibility that the same could happen to us; that we might be shunned by society, too.
The shield of stigma also stops us from seeking help for our own mental health. When faced with a stressful life event or emotional challenges, we might carry the hurt or confusion inside. Perhaps we avoid facing a potential diagnosis, so our illness only grows worse. Stigma facilitates mental illness turning into the “monster” it doesn’t have to be.
Social perceptions need to change. However, stigma is so deeply rooted in societal norms that it can take a long time to eradicate. And people like me, people living with mental illness, can’t wait on society to change. We need to live now. In fact, we need to be pioneers.
First, we need to overcome our own belief in society’s fears. This requires finding hope, and specifically recognizing the possibility of recovery. Recovery from mental illness is living a full and productive life with mental illness. With this mindset, we can take ownership of our condition and live a fulfilling life. This can be one of the most powerful forces for change.
Stories of living fully with mental illness can help reshape society’s bias. They also provide inspiration and guidance for other people living with mental illness. This is the power of peer support and sharing lived experience. It creates a cycle of more people finding recovery, and then in turn, society seeing more positive examples of people living well with mental illness. Society needs to see what life with mental illness can and should be—a life of possibility, not a life sentence.
When people share their mental health journeys, it also helps set our own expectations. Recovery is hard and there is no smooth path to get there. It’s also not a cure, it requires continuous patience, discipline and determination. There will be stumbles and uncertainties along the way. This is the reality of mental illness. That’s why relatable, real-life examples are so valuable.
Knowing that others are going through similar challenges can help us build resilience. The result is self-empowerment by the example of others. We, the mental health community, rely less on the image society projects upon us, and instead focus on the image reflected to us by our peers. This is the power from within ourselves and our community.
I believe that this type of person-driven recovery has been overlooked as a way to combat social stigma. It’s become so ingrained that not even people with mental illness think recovery is possible. Too many of us allow society’s fears to become our own. Together, we can reverse the vicious cycle of stigma and instead, power the virtuous cycle of hope and recovery.
Katherine Ponte is a Mental Health Advocate and Entrepreneur. She is the founder of ForLikeMinds, the first online peer-based support community dedicated to people living with or supporting someone with mental illness and is in recovery from Bipolar I Disorder. She is on the NAMI New York City Board of Directors.
https://www.nami.org/Blogs/NAMI-Blog/October-2018/The-Power-to-Create-Change-Comes-from-Within
In my children’s book about mental health awareness, Binky Bunny Wants to Know about Bipolar, Binky Bunny sees Mama Bunny sleeping a lot and wonders why she won’t wake up and play with him. When he asks his mom what’s wrong, he learns about bipolar disorder.
Binky learns that Mama Bunny loves him very much, but she needs her naps to function from day to day. It’s not that she’s avoiding Binky, or the chores that need to be done around the house; she wants to work and play, but she was born with an invisible illness in her brain that slows her hop.
Binky learns that he needs to work with his father to help Mama Bunny feel better. He doesn’t want bipolar disorder and its symptoms to keep her from experiencing life’s everyday gifts. Now educated and engaged, Binky is determined to help his mom live in an environment where she can heal.
This book is my way of showing how important it is to talk with our children about all aspects of mental health—including mental illness. As a parent with a diagnosis of bipolar disorder, I’ve already started a dialogue with my 8-year-old son to help him get a better grasp of what’s going on with me. I believe I was given my illness for a reason, and I’m not going to keep quiet about it, especially with my son.
I don’t believe in hiding behind stigma and just telling him I’m tired. I’m upfront and honest, because I believe if we want to live in a society free of stigma, we have a moral obligation to educate our children.
As soon as children are old enough to understand that mommy or daddy isn’t “like the other mommies or daddies,” it’s time to have a talk. It’s OK if they don’t understand right away. Every day is another opportunity for more education. Have a recurring family meeting or a set, consistent time when you all sit down and have a candid conversation about mental health. This will provide repeated opportunities for discussion and for your children to ask questions.
My family does this pretty informally. When my husband and I are together at the end of each day, we ask my son how his day was. This is a perfect opportunity to let your child know if you’re having a good day or if you need a little extra help. For example, on a day when loud noises might be bothering me, I might ask my son to keep it down for me and explain why.
Also use this time to explain how your mental illness is currently affecting your daily routine. If you’re a parent with a mental health condition who needs to be alone or take naps to recharge (like Mama Bunny and me), kids might be worried there’s something wrong with you, or worse, that you don’t want to spend time with them. Make sure they know nothing could be further from the truth. It might not be every day you have to sleep in or take naps, but if you have a particularly sleepy week, reassure your children it’s not something you’re doing to avoid them. Taking a nap is sometimes like taking a shower—just a part of daily hygiene.
I know I don’t have all the answers, so if my son asks me something I’m unsure about during our talks, I’ll seek resources from my doctor or local library. If I need to explain something about mood, depression, mania or hospitalization, I’ll try to find something age-appropriate I can read to my son. But there really isn’t a lot of reading material about mental illness for children. So, I’ll often write down his questions and bring them to my next appointment so my doctor can give detailed, kid-friendly explanations I can bring home.
A few times, I’ve set up appointments for the two of us or our whole family to visit my doctor. My family finds this very helpful because no matter how much research we might do on our own time, bipolar disorder is different for everyone who experiences it. No two people with the same diagnosis have identical symptoms or express their illness in the same way. So, it’s great when my family can get together to talk to my mental health professional, who helps me with my illness, about how we can all cope together as a family. When we leave, we feel like we’re all on the same page.
This might not be a popular opinion, but I think children should also be informed of the medications their parents are taking. Medications for depression cause certain side effects, while medications for psychosis cause other side effects and medications for anxiety cause different side effects still. I think it’s important for children to know what to expect.
And it’s OK to tell children that having to take medication for your illness is something not under your control. Just like how they need shots to stay healthy or take antibiotics when they get sick—with mental illness comes medication. We might not like it, but we need it.
Teaching kids about mental health should not stop once they leave the house. School is an important place for them to learn more, and school counselors and teachers should have resources about mental illness and suicide. It’s also beneficial for a child to have a non-biased counselor to talk to if they have questions they don’t feel comfortable asking you, or if they’re having mental health concerns about themselves.
A great resource for schools is NAMI Ending the Silence, an in-class presentation in which students learn about mental illness from someone with lived experience. Having conversations and learning about mental health in school will only reinforce the information you share with your child at home. The more education your child receives about mental health, the more important it will seem.
As parents, we’re not mind-readers, and we can’t afford to pretend we are. That’s why it’s so important to communicate with our children about mental illness—even if it’s difficult to talk about or explain. We never know what they might be thinking, and it’s only fair to you and your children to be honest about your mental health.
I wrote my children’s books about bipolar disorder because my son was starting to ask questions, and I’d rather he learn from me about mental illness than the callous things he might learn from those who aren’t educated.
I’ve seen amazing ripple effects since starting our talks: My son now educates others on the topic. He has tools in his toolbox to use if someone says something about mental illness he knows isn’t true.
To help end stigma, we need to start with our own children. So if you’re a parent living with mental illness, fill your house with love and mental health awareness. Don’t procrastinate, educate. And feel free to use Binky Bunny. Together, we can all hop to stop stigma!
Kathleen Boros is originally from Massachusetts and was brought up in Florida. She’s been married for 15 years and has an 8-yearold son. She was diagnosed with bipolar disorder at 19 and is now 41. She received a bachelor’s in behavioral science and a master’s in special education. She enjoys writing to educate children and their families about mental illness. Join her efforts to educate children on mental health with Binky Bunny.
https://www.nami.org/Blogs/NAMI-Blog/November-2018/Talking-to-Kids-About-Mental-Illness
By: Jessica Maharaj
The “most wonderful time of the year” can quickly turn into the most stressful time of the year for many. When compounded by a mental illness, common holiday pressures can create a perfect storm of exacerbated stressors, symptoms and setbacks if not proactively addressed.
The reality is that potential hazards exist at every turn during the holidays. These situations can trigger heightened difficulties for people suffering from depression, anxiety, PTSD and other mental illnesses. The holidays can also introduce additional stressors such as complicated relationship dynamics at family gatherings, grief over losing a loved one or simply trying to live up to the unattainable expectations of the “perfect holiday.”
While it’s important that all people consider the impact of the holidays on emotional well-being, it is crucial that those with mental illness consider tactics for avoiding pitfalls. Of all the things on your holiday preparation to-do list, the most critical one is maintaining your mental health and practicing self-care.
Major Depressive Disorder with a Seasonal Pattern (formerly known as seasonal affective disorder, or SAD), is a form of depression that often accompanies changes in seasons. This disorder results from chemical changes in the brain and body and is best controlled with the help of a mental health professional who understands the nuances of treating this condition. Whether through online, remote care options such as telepsychiatry or in-person treatments, seeking professional support is truly beneficial in proactively managing this condition leading up to, during and following the holiday season.
Symptoms of SAD can become more pronounced as the holidays approach. These tips can help you manage your symptoms during the holidays.
One of the greatest holiday stresses is the absence of a loved one who passed away. The empty seat where they would have sat can fill families with a sense of grief, loss and emptiness, as well as worsen symptoms for individuals with mental illness. The following recommendations can help you and your family cope:
Keep in mind that the loved ones you lost would want you to remember them fondly, to enjoy the holiday season, and to find comfort in having the family come together.
The holiday season only comes once a year, and while it’s understandable to aspire for perfection, it’s important to set realistic, attainable goals. The following are a few key tips for avoiding the stress of perfection.
Keep in mind that the holidays are about spending time with loved ones, not gifts. Your friends and family will be happy to create memories with you, so don’t worry about finding an expensive gift or if they will like it; they will appreciate your efforts and affection regardless of what you give them.
The holidays bring joy and happiness as well as frustration and stress. This holiday season, you may have many things to take care of, but the most important one is yourself.
Jessica Maharaj, a Certified Nursing Assistant, is currently pursuing a master’s degree in Clinical Mental Health Counseling at George Washington University while also working at InSight Telepsychiatry. She earned a Bachelor of Science degree in Psychology with a second major in Biology and a concentration in Human Services from the University of Maryland, Baltimore County (UMBC). Jessica was the President of UMBC’s campus chapter of NAMI during her undergraduate career.
https://www.nami.org/Blogs/NAMI-Blog/December-2018/Avoiding-Holiday-Stressors-Tips-for-a-Stress-Free-Season
For most my life, my mom and I have had a turbulent relationship. Vague reassurances from others that “everyone has family problems” never helped with our nonsensical fighting or how I felt. I never knew what to do, but I knew it had to stop.
Family relationships are sometimes responsible for life’s biggest conflicts. They’re often complicated and can span decades. For many, it’s the steady drip of unresolved arguments and personality clashes that leave lasting feelings of resentment and bitterness. But there is a way to work through this. There is a hopeful course of action—it’s called family therapy.
Family therapy is a collaborative and inclusive process which focuses on the family as a unit. Family therapists are skilled in dealing with a variety of conflicts whether it involves communication issues, estrangement, financial problems, divorce, a death in the family and more.
There might be a time before starting therapy when you won’t want to go. I certainly didn’t. My mom certainly didn’t. The pains of having to sift through years of battles wasn’t appealing. But without confronting the past, we are bound to repeat the same mistakes. Therapy may lead to the resolution you’ve been searching for. It’s important to give it a chance.
I knew that the family therapist I chose was effective because within our first few sessions, I felt comfortable. I knew I would be able to open up to her. And I never dreaded talking in session. She also brought up Narcissistic and Borderline Personality Disorder in regards to my mother. This helped me to trust my therapist and her expertise even more, because she was able to spot that early on.
If you feel that a therapist is not effective, it’s okay to keep looking. In my experience, most therapists don’t take it personally. In fact, they encouraged my family to find the right fit for us. Your comfort level and ability to open up are essential in a therapeutic relationship.
Over time, your therapist will learn your family’s communication style. Some families are louder than others, while some fill the minutes with silence. Certain family members may be withdrawn at tense moments, while others might be aggressive. Your therapist will be see these differences and guide each of you accordingly.
A typical therapy session is 50 minutes, once a week. It’s a short amount of time to work through a lot of issues among multiple people. In order to best use your time with your therapist, here are a few tips to have effective sessions.
You may feel as though your family will never resolve long-standing conflicts. But it is possible. With listening and restraint, your family can reaffirm its bond and clear up old disagreements and hurt. Or you may decide it’s time to move on. For me, the decision to lessen contact with my mother, while controversial to some, was the right choice. I am no longer consumed with guilt about not being able to get along. Without therapy, I know I would still have an extremely close and volatile relationship with her.
Because it was such a positive and powerful experience for me, I always recommend family therapy to others. Even the more exhausting and uncomfortable sessions were necessary. Without them, I wouldn’t have been able to identify toxic patterns of behavior, understand my depression, or take control and realize what I needed to do in order to change my life.
There is nothing to fear about family therapy—it’s a safe place to work through negative feelings and move forward. Any decisions you make with your family will be based off careful discussion and thought. When I look back now, I know I wouldn’t have made the same choices without the support of my therapist.
Amanda C. Dacquel is a mental health writer and advocate. In 2014, she started TheCurrentCollective.com to share mental health experiences, resources and news. You can connect with her at AmandaDacquel.com.
I was sitting alone in the hallway of the Carter Center conference area in Atlanta during the 2012 Rosalynn Carter Symposium on Mental Health Policy. I had just finished being a panelist and talking about how employment and education helped me overcome the stigma associated with my depression. The conference was still in session, so I had the hallway to myself. I sat quietly, reflecting on the fact that I had been invited to speak here as both a clinician working in community mental health and a person living with depression.
Two scenes flashed through my mind highlighting two very different points in my life: getting offered a job as a therapist at the mental health center where I completed my internship for my Master’s in social work, and sitting in a psych ward on the eve of my 18thbirthday, wondering if I would graduate from high school.
It took many years of perseverance for me to become that professional sitting on a panel at a national conference. Though I managed to graduate from high school, I dropped out of college at 19 as my depression worsened. I was unemployed, and my only income was Social Security disability. Years of failed depression treatments included medication and talk therapy.
I spent most of my time alone doing what I refer to as “stewing in my own depressive juices.” This lasted for 10 years. During that time, I was challenged by the symptoms of mental illness— insomnia, loss of appetite, lack of concentration, suicidal thoughts. After a decade of being unemployed and living on Social Security, I decided that for my own survival, I had to return to school and complete my social work degree. Of course, my depression was against this:
“You can’t go back to school; you will fail.”
“You won’t be able to concentrate enough to complete your assignments.”
“You’re too stupid to get a college degree.”
Somehow, I decided to talk back to these negative thoughts. My response was simple: “I’m just going to do the best I can.”
And I did. I got myself back to school and finished my degree in social work. Around that time, I also tried a different treatment for my depression, and it worked. Things got easier.
Today, I feel incredibly lucky to say that I am doing exactly what I want to be doing. But really, luck had little to do with it. Besides my symptoms of depression, I faced an additional barrier to school, employment and inclusion in general: unhelpful attitudes from well intentionedhealth professionals—in other words, stigma.
One mental health professional once told me, “Maybe you’re not getting better because you’re not trying hard enough.” Another warned me, “You might not be ready to go back to school full time. Shouldn’t you just take one class and see how that goes?” A psychiatrist decided, without asking for my opinion, that I should be sent to live in a group home for people with mental illness. (That did not happen, and that treatment relationship ended that day.)
These scenarios were fueled by the stigma associated with mental illness—stigma that ultimately serves to limit and exclude rather than encourage and include. Had I listened to those professionals, I might never have returned to school or entered the workforce.
So how did I overcome the stigma that I faced? I rejected it. Rejecting—or overcoming—stigma, whether it be self-stigma, public stigma or structural stigma, is one of the keys for those of us living with mental illness. This is not an easy task, to be sure, but it is becoming more possible and a bit easier as more and more of us of speak out about our mental health conditions.
After working as a therapist and witnessing the negative effects of stigma on clients and their family members, I decided to develop a stigma-reduction training curriculum called “Overcoming Stigma.” I spent several months reading every scientific article I could find about stigma research. Most of it simply documented that stigma exists (in hospitals, in psychiatry, in substanceusetreatment centers, in pharmacies, universities, employment, housing, etc.) and that levels of stigma have not changed over the last decade.
According to many studies, effectively reducing stigma pointed to one intervention: contact with someone successfully managing a mental illness. One shining example of this is NAMI’s In Our Own Voice (IOOV) program. People with mental health conditions share their powerful personal stories in this free 60- or 90-minute presentation. I decided to integrate elements of IOOV into the beginning of my trainings by briefly disclosing my own depression and giving a few examples of my experiences with stigma. The rest of the training includes a description of the seven most common types of stigma experienced by people with mental illness and substance-use disorders, research about the effects of these stigmas, ways to reduce stigma, and the clinical and agency assessment tools I developed.
I have presented Overcoming Stigma trainings in many different health care settings, and the curriculum continues to evolve, always guided by the latest stigma research. Recent research shows that stigma training needs to be ongoing instead of a one-time thing and, it likely needs to address many stigmas all at once.
My trainings get everyone involved in the discussion; I like to ask for anecdotes from attendees. Here are some real-life examples of stigma shared by health care professionals who have attended my trainings over the past several years:
• A cardiac surgeon said he would not do surgery on a person with schizophrenia because he didn’t think the person would be able to do the required follow-up care.
• A therapist shared that as a Ph.D. student, he was told he would lose his scholarship if he left for “depression” treatment but could keep it if he left for “medical” treatment.
• A mother puts off making an appointment for her daughter to see a therapist despite her daughter experiencing severe symptoms of anxiety because she doesn’t want her daughter to be labeled as “crazy.”
• A physician attendee said it was well known in her neighborhood that her son had been hospitalized with bipolar disorder and no one acknowledged this fact (much less offered any type of support).
• A mental health clinician working in an emergency room said doctors and nurses often referred to patients in the ER with mental illness as “her patients,” rather than “our patients.”
If I do my job well, attendees leave with the understanding that we all have a role to play in reducing these harmful kinds of stigma. Personally, I still experience stigma, but I am no longer limited by it. I sometimes even chuckle when I hear someone say something particularly stigmatizing because I immediately think, “Well, that’s going to be part of my next training.” That’s not to say it isn’t still discouraging to see or hear things that continue to perpetuate stigma, but for me, there is a feeling of freedom and power in being able to turn a potential lost opportunity into one that is gained.
Gretchen Grappone, LICSW is a trainer and consultant with Atlas Research in Washington, D.C. Her work includes projects with VA medical centers, community mental health centers and other health care settings around the country. She lives in New York City.
https://www.nami.org/Blogs/NAMI-Blog/October-2018/Overcoming-Stigma
As I was entering medical school, I found out that my mother had made a postpartum suicide attempt. I did not find out from her; it was shared with me in hushed tones by another family member who thought I should know, “now that I was going to be a doctor.” I was quite surprised by this information. And it made me sad to think that this wasn’t a topic she felt she could openly discuss.
Suicide is a challenging issue for all of us. Secrecy surrounds the topic, with shame as a common co-traveler. That’s why it’s an honor for me to be a small part of NAMI’s movement to make seeking help and support more acceptable. I’ve met many resilient people in the NAMI community who have overcome suicidal thoughts or actions. Often because there was a person who stood by them during a crisis or a new treatment approach that made a difference in their life. Some found sobriety for a co-occurring substance use disorder. Others found clozapine or lithium, which have been shown to reduce suicidal thinking. Some learned coping skills through a psychotherapy like cognitive behavioral therapy or dialectical behavioral therapy. Many found relief in the community of NAMI. Regardless of how, their suicidal thoughts or actions were talked about and changed.
My field sorely needs similar conversation and change. Doctors also have high rates of suicide and it’s a major issue that some of the doctors we turn to for care are often not taking care of themselves. We need to teach help-seeking behaviors in the medical and psychiatric fields. Doctors need the same support and encouragement to get help as their patients.
I lost a patient to suicide early in my psychiatric residency. This was a person with many strengths, who was also in tremendous psychological pain. I worried about him during off-hours and felt powerless to help at times. After I learned of his tragic outcome, I was upset, slept poorly and struggled at work for months. I was worried I had said the wrong thing or had failed in some way as an inexperienced psychiatrist. I seriously considered leaving the field and entering another specialty. I was lucky to receive support and empathy from my colleagues and supervisors as they encouraged me to seek therapy. I did my best to carry on, but I never forgot about this patient and his suffering.
Last year, at an American Psychiatric Association (APA) event, I was impressed that even doctors are wondering if they worry, struggle and stress too much. APA president Anita Everett reviewed the stresses that commonly consume doctors and announced that psychiatric wellness would be a core feature of her leadership. Dr. Everett’s thoughtfulness and openness on the stresses doctors face and her emphasis on help-seeking was powerful; her efforts have started many overdue conversations across the entire field of medicine. Unfortunately, the same shame that led to the secrecy around my mother’s postpartum suicide attempt is alive and well in the medical field.
Doctors don’t have all the answers for stress, mental illness and suicide—our most challenging aspects of being human. Medical culture needs to continually evolve and learn from the remarkable and resilient people like those I have met at NAMI. Facing your mental health challenges head-on and working to get help with a supportive community behind you is a key piece of NAMI culture. It’s a culture we can all learn from.
Ken Duckworth is medical director at NAMI.
https://www.nami.org/Blogs/NAMI-Blog/September-2018-(1)/Reflections-on-Medicine-Shame-and-Stigma
Suicide affects all people. Within the past year, about 41,000 individuals died by suicide, 1.3 million adults have attempted suicide, 2.7 million adults have had a plan to attempt suicide and 9.3 million adults have had suicidal thoughts.
Unfortunately, our society often paints suicide the way they would a prison sentence—a permanent situation that brands an individual. However, suicidal ideation is not a brand or a label, it is a sign that an individual is suffering deeply and must seek treatment. And it is falsehoods like these that can prevent people from getting the help they need to get better.
Debunking the common myths associated with suicide can help society realize the importance of helping others seek treatment and show individuals the importance of addressing their mental health challenges.
Here are some of the most common myths and facts about suicide.
Myth: Suicide only affects individuals with a mental health condition.
Fact: Many individuals with mental illness are not affected by suicidal thoughts and not all people who attempt or die by suicide have mental illness. Relationship problems and other life stressors such as criminal/legal matters, persecution, eviction/loss of home, death of a loved one, a devastating or debilitating illness, trauma, sexual abuse, rejection, and recent or impending crises are also associated with suicidal thoughts and attempts.
Myth: Once an individual is suicidal, he or she will always remain suicidal.
Fact: Active suicidal ideation is often short-term and situation-specific. Studies have shown that approximately 54% of individuals who have died by suicide did not have a diagnosable mental health disorder. And for those with mental illness, the proper treatment can help to reduce symptoms.
The act of suicide is often an attempt to control deep, painful emotions and thoughts an individual is experiencing. Once these thoughts dissipate, so will the suicidal ideation. While suicidal thoughts can return, they are not permanent. An individual with suicidal thoughts and attempts can live a long, successful life.
Myth: Most suicides happen suddenly without warning.
Fact: Warning signs—verbally or behaviorally—precede most suicides. Therefore, it’s important to learn and understand the warnings signs associated with suicide. Many individuals who are suicidal may only show warning signs to those closest to them. These loved ones may not recognize what’s going on, which is how it may seem like the suicide was sudden or without warning.
Myth: People who die by suicide are selfish and take the easy way out.
Fact: Typically, people do not die by suicide because they do not want to live—people die by suicide because they want to end their suffering. These individuals are suffering so deeply that they feel helpless and hopeless. Individuals who experience suicidal ideations do not do so by choice. They are not simply, “thinking of themselves,” but rather they are going through a very serious mental health symptom due to either mental illness or a difficult life situation.
Myth: Talking about suicide will lead to and encourage suicide.
Fact: There is a widespread stigma associated with suicide and as a result, many people are afraid to speak about it. Talking about suicide not only reduces the stigma, but also allows individuals to seek help, rethink their opinions and share their story with others. We all need to talk more about suicide.
Debunking these common myths about suicide can hopefully allow individuals to look at suicide from a different angle—one of understanding and compassion for an individual who is internally struggling. Maybe they are struggling with a mental illness or maybe they are under extreme pressure and do not have healthy coping skills or a strong support system.
As a society, we should not be afraid to speak up about suicide, to speak up about mental illness or to seek out treatment for an individual who is in need. Eliminating the stigma starts by understanding why suicide occurs and advocating for mental health awareness within our communities. There are suicide hotlines, mental health support groups, online community resources and many mental health professionals who can help any individual who is struggling with unhealthy thoughts and emotions.
Kristen Fuller M.D. is a family medicine physician with a passion for mental health. She spends her days writing content for a well-known mental health and eating disorder treatment facility, treating patients in the Emergency Room and managing an outdoor women’s blog. To read more of Dr. Fuller’s work visit her Psychology Today blog and her outdoor blog, GoldenStateofMinds.
